European journal of emergency medicine : official journal of the European Society for Emergency Medicine
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Randomized Controlled Trial Comparative Study
Comparison of the Airtraq laryngoscope versus the conventional Macintosh laryngoscope while wearing CBRN-PPE.
The rapid management of respiratory failure after exposure to a CBRN agent (chemical, biological, radiological and nuclear) is a priority leading to a decrease in mortality. We studied the performance of orotracheal intubation (OTI) with the Airtraq laryngoscope compared with the Macintosh laryngoscope by emergency physicians in protective CBRN type III personal protective equipment. ⋯ This study on manikins shows that the Macintosh laryngoscope is superior to the Airtraq laryngoscope in terms of OTI speed, efficiency, and overall ease of use. The Macintosh device is one of the alternatives in the OTI of normal airways by emergency doctors in CBRN personal protective equipment clothing.
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Comparative Study Observational Study
Point-of-care troponinT is inferior to high-sensitivity troponinT for ruling out acute myocardial infarction in the emergency department.
Point-of-care testing (POCT) cardiac troponin (cTn) measurements are being used increasingly, despite the fact that evidence on the safety of their use is outdated, not taking into account current 'gold standard' high-sensitivity cardiac troponin (hs-cTn) assays. In the present study, we aimed to compare the analytical and diagnostic performance of the AQT90-flex POCT cTnT assay (which is the POCT assay with the lowest reported 99th percentile cutoff currently available) with the laboratory-based Roche Modular E170 hs-cTnT assay. ⋯ The AQT90-flex POCT cTnT assay is not yet sensitive and reliable enough to be used to exclude AMI in the ED with a single blood draw at the time of presentation in the ED, and therefore, may have limited applicability in the ED setting.
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Recognition of cardiac arrest (CA) during an emergency call leans on questions concerning CA symptoms and is correct in 50-83% of cases. If the heart rhythm could be recorded and analysed over a mobile phone or transmitted during the emergency call to the dispatch centre and analysed there, using software identical to one in an automated external defibrillator (AED), CA recognition could be more prompt. We investigated whether an AED can correctly analyse normal heart rhythms recorded within an area the size of a mobile phone. ⋯ ECGs can be analysed promptly with an AED within an area the size of a mobile phone. The most reliable recording position was vertical at the midsternum level.
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The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias. ⋯ Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.